When choosing an infiltrative
anesthetic agent, the type of procedure, the length of time required for
anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with
sodium bicarbonate can be used to decrease the
pain associated with injection. Local cutaneous infiltration is the most commonly used
anesthetic technique and involves direct injection into the area requiring
anesthesia. Field blocks provide
anesthesia by circumferentially blocking innervation to the area.
Nerve blocks target the innervation to a specific area and are useful on the face and digits. Using easily identifiable landmarks, blockade of the supraorbital, supratrochlear, infraorbital, and mental nerves can provide site-specific
anesthesia. Dorsal and palmar or plantar digital
nerve blocks can be performed at a variety of locations on the hands and feet.